This cross-sectional population-based survey focused on the coverage of clinical breast examination (CBE) in women 20 to 60 years of age in São Leopoldo, Rio Grande do Sul State, Brazil, and described the factors associated with lack of CBE. The outcome was defined as having received a CBE by a physician during the year prior to the interview. Two different multivariate models were analyzed. Among the 1,026 women included in the sample, 556 (54.2%; 95%CI: 51.1-57.2) had received CBEs. Multivariate analysis including the entire sample of women showed that low socioeconomic status (SES) was the only variable associated with not having a CBE. In the other multivariate model (only women who had consulted physicians in the previous year, with or without CBE), a statistically significant effect was found for both SES and skin color. Thus, low SES was significantly associated with lack of CBE in both models. However, in the model limited to women with physician consultations in the previous year, skin color was the main factor for receiving CBE, suggesting that once differences in initial access to the health service were overcome, white women had a higher probability of receiving a clinical breast examination as part of their consultation.